预防深静脉血栓的循证护理实践工作模式的构建研究

doi:10.3761/j.issn.0254-1769.2024.15.002

摘要/Abstract

摘要：

目的构建预防深静脉血栓（deep vein thrombosis，DVT）的循证护理实践工作模式，为护士开展预防DVT循证护理实践提供较为科学且有针对性的理论依据。方法以课题小组前期开展的预防髋膝关节置换术后DVT循证护理实践项目为支撑，课题小组采用理论分析法、头脑风暴法构建工作模式初稿，采用专家会议法对初稿内容进行论证，确定预防DVT的循证护理实践工作模式。结果选择知识转化模式作为构建预防DVT的循证护理实践工作模式的基本框架；依据理论域框架、计划行为理论和社会认知理论对预防DVT循证护理实践行为改变的影响因素进行深入探讨；与会专家权威系数为0.904，专家权威程度高，结果可靠。最终构建的预防DVT的循证护理实践工作模式主要包括知识产生、发现问题、本土化调试、知识应用、知识的持续使用、循证实践行为改变的概念框架6个方面的内容。结论该研究在理论分析的基础上，结合临床实践，运用专家会议法制订了预防DVT的循证护理实践工作模式，制订方法科学，研究内容可靠，为护士开展预防DVT的循证护理实践提供理论依据。

关键词: 深静脉血栓, 循证护理实践, 工作模式, 循证护理学, 专家会议法

Abstract:

Objective To construct an evidence-based practice model for nurses in preventing deep vein thrombosis（DVT） and provide a scientific and targeted theoretical basis for nurses to carry out evidence-based nursing practice in DVT prevention. Methods Based on the previous evidence-based nursing practice project on DVT prevention after hip and knee arthroplasty，the research team used theoretical analysis and brainstorming to develop a draft of the work model. Expert meetings were organized to validate the content of the draft using the Delphi method，leading to the finalization of the evidence-based practice model for nurses in preventing DVT. Results The Knowledge-to-Action（KTA） framework was selected as the basic framework for constructing the evidence-based nursing practice model for preventing DVT. Theoretical Domain Framework，Theory of Planned Behavior，and Social Cognitive Theory were chosen to explore the influencing factors of nurses’ behavior change in preventing DVT through evidence-based practice. The authority coefficient of the participating experts was 0.904，indicating high reliability. The final model consisted of 6 key components：knowledge generation，problem identification，localization and adaptation，knowledge application，sustained knowledge use，and conceptual framework for behavior change through evidence-based practice. Conclusion Based on theoretical analysis and clinical practice，this study developed an evidence-based practice model for nurses in preventing DVT using the expert meeting. The research methodology was scientific，and the content was reliable，providing a theoretical basis for nurses to engage in evidence-based nursing practice for DVT prevention.

Key words: Deep Vein Thrombosis, Evidence-Based Nursing Practice, Working Model, Evidence-Based Nursing, Expert Meeting

王钰, 郝玉芳, 马玉芬, 徐园, 安然逊, 邓海波, 王磊, 王晓杰, 孙建华, 刘佳, 朱丽筠, 吴欣娟. 预防深静脉血栓的循证护理实践工作模式的构建研究[J]. 中华护理杂志, 2024, 59(15): 1804-1811.

WANY Yu, HAO Yufang, MA Yufen, XU Yuan, AN Ranxun, DENG Haibo, WANG Lei, WANG Xiaojie, SUN Jianhua, LIU Jia, ZHU Liyun, WU Xinjuan. Development of a working model of evidence-based nursing practice in deep vein thrombosis prophylaxis[J]. Chinese Journal of Nursing, 2024, 59(15): 1804-1811.

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